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SGPT numbers up
Apr 25, 2006

I am on Susteva, Epivir, and Viread. I am 58 years old. I was diagnosed May 7, 2003. I had a T-cell count 107, 7%, and a viral load of 260,000. Within 6 months my viral load was undectectable but my T-cell count has fluctuated as high as 242 and as low as 97.and my percentage has gone up steadily to 18 to 21 percent. I have had some squamous skin cancer and have had surgery and some radiation treatments which has caused the fluctuation in T-cells but the percentage has been constant and I have stayed undetectable. I am faithful and take my medications every day at at the proper intervals. My concern is my liver functions have gone from normal (SGOT 25 SGPT 45) are now at high levels (SGOT 71 SGPT 190). My lab shows the normal ranges as; SGOT 15-37 and SGPT 30-65. I talked to my infectous desease doctor and he does not seem concerned. My primary care doctor seems more concerned. Should I look at changing my meds? My T-cell count is 169, my percentage is 18, and I am still undetectable below 50 copies. What would you suggest I do?

Response from Dr. Daar

While your liver enzymes are clearly elevated, this alone without any symptoms is no reasons to make any immediate decisions. There are many potential explanations for your elevation in liver enzymes that should be considered. First of all, it would be helpful to know what your other liver tests are doing, such as you bilirubin and alkaline phosphotase.

Immediate things to consider is whether this is drug related, and not just your antiretrovirals but any other drugs you are on. This could include prescription medications, as well as any other substances you are using from over the counter medications, including Tylenol, vitamins, herbs, alcohol or illicit drugs. In addition, it would be important that you be evaluated for viral hepatitis, particularly hepatitis B and C. I would start with these considerations. If the liver tests continue to remain elevated, or rise without any explanation being identified you and your provider can discuss having an imaging study done, such as an ultrasound or CT scan, and possibly consultation with a liver specialist.

I would suggest you talk to your provider and come up with a plan to assess these various possibilities and proceed one step at a time.

Best, Eric

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